BANDAGING Bandaging is both a science and an art. The proper bandage, properly applied, can aid materially in the recovery of the patient. A carelessly or improperly applied bandage can cause discomfort to the patient and may imperil his life. Thus, it is important that enlisted men of the Medical Department should become familiar with the various bandages and be able to apply them properly. The following pages will aid the student and the teacher; but the art of bandaging can be mastered only by constant practice. USE OF BANDAGESBand ages are empl oyed to hold dressi ngs, to secure splin ts, to creat e pressu re, to immobilize (make immovable) joints and in correcting deformity. Bandages should never be used directly over a wound. They should only be used over a dressing. - To s upport f ract ured bones - To immob ili ze di slocated shou lde r or jaw - To apply pre ssure, stop bleedi ng and impro ve ven ous bl ood fl ow - To s ecur e dr essi ng in p lace - To retain spli nt s i n place PRINCIPLES AND PRCEDURES - Was h han ds( wea r glo ves when necessary) - Assist to a ssume c omfor table positi on on bed or c hair and suppo rt the body part to be bandaged. - Always sta nd in fron t of the par t/victim to be band age d except when apply ing a bandage to the head, eye and ear. - Be sure the bandage i s ro lle d fi rml y. - Make sure the b ody part t o be banda ged i s clean an d dry . - Assess skin befor e applying bandage for a ny br eakdown. - Observe circulatio n by noting pu lse, surf ace temp erature, skin color and sensatio n of the body part to be wrapped. - Always start bandaging from inner to outer aspect and far to near e nd. When bandaging a joint, ensure flexibility of the joint. (Except immobilization of joint is required) - Always star t and e nd with t wo ci rcu lar t urns. - Cover t he area 2 inches above and 2 in ches b elow t he aff ected area - Overl ap t urns and sligh tly s tretc h t he b anda ge. - Cover 2/3 of the pr evious turn. - Wher e possib le, leav e finge rtips or t oe tips ex posed f or obse rvati on(ad equac y ofblood circulation) - End the banda ge on the o uter si de of the body. Do n ot end ba ndage on wou nd or at the back of the body. TYPES OF BANDAGES 1. Triangular ba ndage -could be used on many parts of the body to support and immobilize. 2. Crape Ban dage -type of woven gauze which has the quality of stretching. 3. Gauze/cotton band age -lightly woven cotto n mater ial. Frequent ly used to retai n dress ings fingers, hands, toes, feet, ears, eyes, head. 4. Adhesive ba ndage -used to retain dressing and also used where application of pressure to an area is needed. METHODS OF APPLYING BANDAGES - Circular - Spiral - Sp ir al Re ve r se - Fig ure of Ei ght - Recurrent - I. CIRCULAR TURN
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Bandaging is both a science and an art. The proper bandage, properly applied, can
aid materially in the recovery of the patient. A carelessly or improperly applied bandage can
cause discomfort to the patient and may imperil his life. Thus, it is important that enlisted
men of the Medical Department should become familiar with the various bandages and be
able to apply them properly. The following pages will aid the student and the teacher; but the
art of bandaging can be mastered only by constant practice.
USE OF BANDAGES
Bandages are employed to hold dressings, to secure splints, to create pressure, toimmobilize (make immovable) joints and in correcting deformity. Bandages should never be
used directly over a wound. They should only be used over a dressing.
- To support fractured bones
- To immobilize dislocated shoulder or jaw
- To apply pressure, stop bleeding and improve venous blood flow
- To secure dressing in place
- To retain splints in place
PRINCIPLES AND PRCEDURES
- Wash hands(wear gloves when necessary)
- Assist to assume comfortable position on bed or chair and support the body part to
be bandaged.
- Always stand in front of the part/victim to be bandaged except when applying a
bandage to the head, eye and ear.
- Be sure the bandage is rolled firmly.
- Make sure the body part to be bandaged is clean and dry.
- Assess skin before applying bandage for any breakdown.
- Observe circulation by noting pulse, surface temperature, skin color and sensation
of the body part to be wrapped.
- Always start bandaging from inner to outer aspect and far to near end.
When bandaging a joint, ensure flexibility of the joint. (Except immobilization of joint
is required)
- Always start and end with two circular turns.
- Cover the area 2 inches above and 2 inches below the affected area
- Overlap turns and slightly stretch the bandage.
- Cover 2/3 of the previous turn.
- Where possible, leave fingertips or toe tips exposed for observation(adequacy of
blood circulation)
- End the bandage on the outer side of the body. Do not end bandage on wound or at
the back of the body.
TYPES OF BANDAGES
1. Triangular bandage
-could be used on many parts of the body to support and immobilize.
2. Crape Bandage
-type of woven gauze which has the quality of stretching.
3. Gauze/cotton bandage
-lightly woven cotton material. Frequently used to retain dressings fingers,
hands, toes, feet, ears, eyes, head.
4. Adhesive bandage
-used to retain dressing and also used where application of pressure to an area is
A triangular bandage can be folded into a strip for easy application during emergencies.
CRAVAT FOR HEAD OR EAR
INDICATION: The purpose of this bandage is to apply pressure to control hemorrhage from
wounds of scalp, or to hold dressings on wounds of ear or lower scalp. (Applied when thevictim has wound on the forehead)
1. Cover the wound with a dressing and place the middle of the bandage over the
wound as illustrated below.
2. Cross both ends of the bandage and gently pull and wrap them in opposite
directions around the head as illustrated.
3. As illustrated below, tie both ends in square knot, making sure that it is fully tight.
CRAVAT FOR JAW OR CHEEK
INDICATION: The cravat of jaw (mento-vertico-occipital cravat) is used to hold dressings on
the chin, cheeks, and scalp, and as a temporary support to immobilize a fractured or
dislocated jaw. (Applied when there is a fractured jaw or wound on the ear of the victim)
1. After making a triangular bandage into a cravat of proper width, place it under the
chin and carry ends upward with one end longer than the other.
2. Bring longer end over the top of head. Cross both ends on side of head. (Ends shouldnow be of equal length)
3. Pass ends around head in opposite directions and tie with square knot on other side
of head on primary turn of cravat.
CRAVAT FOR THE EYES
INDICATION: The cravat bandage of the eye is used to hold a dressing over the eye. Two
cravats are required. (Applied when there is wound or injury in either of the victim’s eye,
laceration of the eyelids, or lacerated eyeball.)
1. Lay center of first cravat over top of head with the front end falling over uninjured
eye. Bring second cravat around head, over eyes, and over loose ends of first
cravat.
2. Tie in front. Bring ends of first cravat over top of head, tying there and pulling
second cravat up and away from uninjured eye.
SHOULDER-ARMPIT CRAVAT
INDICATION: The shoulder – armpit cravat (bis-axillary) is used to hold dressings in the armpit
(axilla) or on the shoulder. (Applied when there is wound or injury over the shoulders, burns,
or shoulder dislocation.)
1. Place cravat over dressing in armpit so the front end is longer than the back.
2. Carry the ends upward. Bring ends across each other over top of shoulder.
3. Cross ends over back and chest respectively to opposite armpit.
4. Tie ends just in front of uninjured armpit.
CRAVAT OF THE ELBOW
INDICATION: The cravat of elbow is used to hold dressings around the elbow. (Applied when
there is sprain on either right or left elbow of the victim)
1. Bend the arm to approximately 90 degrees and at the elbow and place the mid-portion of the cravat bandage at the elbow bringing and holding the ends of the
bandage upwards.
2. Cross both bandage ends and gently rolled extending both ends downward.
3. Roll both ends gently around the arm and pull both ends opposite the elbow and tie
it in square knot.
CRAVAT OF OPEN PALM
INDICATION: (Applied when there is vertical wound on either right or left palm of the victim.)
1. Apply a dressing to the wounded area and lay the mid of the cravat bandage over
the palm with the ends hanging on both sides.
2. Bring the end of the cravat from the little finger across back of the hand rolling it
upward over the base of the thumb; gently and slightly pull it downward across the
palm.
3. Hold the thumb end of the cravat and roll it across the back of the hand and pull it
over the palm towards the hollow portion of the palm in between the thumb and thepalm.
4. Take both ends to the back of the wrist of the hand and roll them crossing each
other, and then roll them up over the wrist and cross the both ends again.
5. Roll both ends at the back of the hand and tie with a square knot at the top of the
wrist.
CRAVAT OF CLOSE PALM (Applied when there is burned on the hand)
1. Lay the mid of the bandage over the wrist Hold the thumb end of the cravat and roll
it across the back of the hand rolling it upward over the base of the thumb, covering
only the four fingers; gently and slightly pull it downward.
2. Hold the other end of the bandage, roll it across the back of the hand rolling it in
between the thumb and index finger take both ends to the back of the wrist, cross
the ends, then roll them up over the wrist and cross it again.
3. Roll both ends at the back of the hand and tie with a knot at the top of the wrist
CRAVAT OF THE KNEE
INDICATION: The cravat of knee is used to hold dressings around the knee. (Applied when
there is wound in either right or left knee of the victim.)
1. Bend the leg to approximately 90 degrees at the knee and place the middle of the
cravat bandage at the upper portion of the knee bringing and holding both ends of
the bandage downward.
2. Cross both bandage ends and gently rolled extending both ends downwards.
3. After rolling the bandage, at the same time pull both ends, tie both ends tightly
opposite the knee in square knot, and tuck in the remaining ends.
CRAVAT OF THE LEG
INDICATIONS: The cravat of leg is used to hold dressings around the leg.
1. Place center of cravat over dressing.
2. Begin ascending turns with upper end, and descending turns with lower end, with
each turn covering two-thirds of preceding turn until dressing is covered.
3. Terminate by tying both ends in square knot.
CRAVAT ANKLE WRAP
INDICATION: The cravat ankle wrap is used to hold dressings around the ankle.
1. Place the middle of the cravat under the heel of the foot.
2. Then bring the bandage up in back of the heel and around to the front of the ankle.
3. Now criss-cross it in a sort of figure-eight form around the ankle.
4. Tie it firmly in front of the ankle.
SPLINTING
Splint - Any device used to immobilize a fracture or dislocation. It can be soft or rigid,
commercially manufactured or improvised from virtually any object that can provide stability.
Splints are used to support and immobilize suspected fractures, dislocations, or sever
sprains; to help control bleeding; to help control pain; and to prevent further damage to
tissues from the movement of bone ends.
RULES FOR SPLINTING
Do not splint if it will cause more pain for the victim.
Both before and after you apply the splint, assess the pulse and sensation below the
injury. You should evaluate these signs every 15 minutes after applying the splint to
make sure the splint is not impairing the circulation.
Immobilize the joints both above and below the injury.
Splint an injury in the position you found it. If there is no distal pulse or movement,
you may attempt to return the bone to its normal alignment by placing one hand above
the injury and another below. Then pull with gentle traction while moving the injury
back toward the correct anatomical position.
Remove or cut away all clothing around the injury site with a pair of bandage scissor
so you won’t accidentally move the fractured bone ends and complicate the injury.
Remove all jewelry around the fracture site.
Cover all wounds, including open fractures, with sterile dressing before applying a
splint, then gently bandage. Avoid excessive pressure on the wound.
If there is a severe deformity or the distal extremity is cyanotic or lacks pulses, align
the injured limb with gentle traction before splinting, following the guidelines above.
Never intentionally replace protruding bone ends.
Pad the splint to prevent pressure and discomfort to the victim.
Apply the splint before trying to move the victim
When in doubt, splint the injury.
If the victim shows sign of shock, align the victim in the normal anatomical position
and arrangw for immediate transport without taking the time to apply a splint.
TYPES OF SPLINTS
1. Rigid Splint
Are commercially manufactured splints made of wood, aluminum, wire,
plastic, cardboard or compressed wood fibers
2. Traction Splints
Gently pulling the direction opposite the injury, alleviating pain, reducing
blood loss and minimizing further injury.Traction splints are not intended to reduce
the fracture, but simply to immobilize the bone ends and prevent further injury. A
traction splint should be used only for a broken thigh, and should be performed onlyby EMTs or those who have had special training in applying traction splints.
3. Pneumatic (Air) Splints
Are soft and pliable before being inflated but rigid once they are applied
and filled with air. Air splints should only be used on fractures where there is no
deformity, but immobilization is needed. A similar type of splint is the vacuum
splint,
4. Improvised splints
It can be improvised from a cardboard box, cane, ironing board, rolled up
magazine, umbrella, broom handle, catcher’s shin guard, or any other similar
object.
You can also use a self splint( also called an anatomical splint) by tying or
taping an injured part to an adjacent uninjured part. Ex. Splint a finger to a finger a
toe to a toe, a leg to the other leg, or an arm to the chest. An effective improvised
splint must be
Light in weight, but firm and rigid
Long enough to extend past the joints and prevent movements on either
side of the fracture
as wide as the thickest part of the fractured limb
3. Place the injured leg between two padded splints, one extending from the groin
(between the legs), and the second splint corresponding with the first in position
but on the outside of the leg.
4. Secure the splints with four or five triangular bandages, folded as cravats but not
tight enough to limit circulation.Place the victim on a litter and transport him to
the hospital in a reclining position, preferably keeping the injured leg in an
elevated position.
KNEE CAP OR PATELLA
The most common fracture of the knee occurs at the kneecap, as a result of a crushing
below. The great majority of such accidents are sustained in automobile accidents when the
person riding next to the driver is thrown forward against the dashboard.
Knee fractures also result from athletic injuries and other crushing blows. The seat belt has
proven to be the best device for preventing this type of accident in the automobile crash.
Fractured kneecaps are indicated by swelling and pain in the joint. The victim will not attempt
to straighten the knee and it is frequently possible to feel the parts of the broken bone, the
patella.
1. Place the victim in a lying-down position (supine) and protect against shock.
2. Apply cold compresses or ice packs to the injured area to limit swelling and bleeding
3. Place a padded wooden splint, six inches wide and thick enough to support, from the
buttocks to beyond the heel and the underneath side of leg
4. Secure the extended leg which has been placed upon the splint with four or five
triangular bandages, folded as cravats
5. Place the splinted leg in an elevated position and wait for transportation ‘
6. Transport to a hospital and medical help in a lying position
UPPER LEG - FEMURThe upper leg has only one bone, the femur. This bone supports the entire body
weight when a person stands. If the shaft or main portion of the femur is fractured or broken,
the individual will be immobilized at once. The upper end of the femur terminates into a
round ball-like part which fits into the pelvis to form a ball-and-socket joint, the hip joint. It is
not uncommon for the head of the femur to be broken off, especially In older persons, Such
injuries would be the most difficult to ascertain without the x-ray. Fracture of the femur or
upper leg can be protected by either fixation or traction splinting.
1. Keep the victim down and protect for shock.
2. Straighten the leg as gently as possible.
3. Place a padded wooden splint from the armpit on the injured side to six to twelve
inches beyond the feet.
4. Place a second padded wooden splint between the legs, from the groin to some six
to twelve inches beyond the feet. Pad the area over the crest of the ileum to
lessen pressure on the greater trochanter of the femur.
5. Secure the two splints with six to eight triangular bandages folded as cravats. Placethree or four of these cravats around the two splints and the injured leg,
between the ankle and the groin; then with two or three additional cravats tie
around the torso and the long splint.
6. Secure the two legs together, from hip to feet with two or three more triangular
bandages as cravats.
7. Keep the victim down and comfortable until transportation is available to medical
help.
PELVIS OR HIP
Fractures of the pelvis are most common in older people and usually result from
falls. Fractures of the pelvis to persons of all ages are common in crushing-type injuries, such
as result from automobile accidents. If there is any likelihood of a fracture to this area, the
victim should not be permitted to get on his feet. It is dangerous because bone fragments
could penetrate the bladder, reproductive organs, intestines, blood vessels, and nerves.
Indications of a fractured pelvis are pain, inability to lift or move the leg, false position of the
leg and/or foot, and a deep bruise. Frequently the leg and foot assume a turned-out position.
The first-aid protection for a fracture of the pelvis is the use of fixation splinting.
1. Place the victim in a lying-down position (supine) and gently straighten the leg. The
victim should be protected against shock.
2. Place a padded splint, a board six to twelve inches wide and at least an inch thick,
beneath the victim on the injured side. The splint should extend several inches
beyond the head and the feet.
3. Place a folded blanket or pad between the victim’s legs.
4. With three triangular bandages folded as cravats, secure the leg to the splint, with
three more cravats, secure the upper body or torso to the splint.
5. With two or three additional cravats, secure the two legs, going around the legs,
splint, and folded blanket.
6. Transport the victim to the hospital in an ambulance or other suitable conveyance.
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SPINAL INJURY
VICTIM ASSESSMENT To assess a responsive victim:
1. Note the mechanism of injury- especially the type of movement and amount of force
that was involved in the injury. Even if a victim can move or walk around, spinal
injury may exist- so always suspect spinal injury if the mechanism of injury
suggests it.
2. Ask:
Does your neck or back hurt? Pain from a spinal injury often radiates from
the neck to the arms, from the upper back to the ribs, and from the lower back
to the legs- so pain maybe confined to the neck or back.
• Used to move a conscious or unconscious casualty.
• Used to move a casualty up or down steps or low drops or to quickly move a
casualty from a life-threatening situation.
PERFORM THE CRADLE DROP DRAG
1. Position the casualty on his back.
2. Kneel at the casualty's head.
3. Slide your hands (palms up) under his shoulders and grasp the clothing under hisarmpits.
4. Partially rise, pulling the casualty to a semi-sitting position.
5. Support his head on one of your arms.
a. If possible, bring your elbows together and use both forearms to support
the head.
6. Rise to a stooped position.
7. Walk backward, dragging the soldier backward.
8. If you go down steps, let his hips and legs drop from step to step.
Shoulder drag
• The shoulder drag is accomplished by placing the victim in a supine position
(laying on his back), grasping shoulders, and dragging him in the desired
direction
Clothing Drag
1. Tie the patient's wrists together if you have something quickly available. If nothing is
available, tuck the hands into the waist band to prevent them from being pulled
upwards.
2. Clutch the patient's clothing on both sides of the neck to provide a support for the
head.
3. Pull the patient towards you as you back up, watching the patient at all times. Thepulling force should be concentrated under the armpits and NOT the neck.
Blanket Drag
1. Lay a blanket lengthwise beside the patient.
2. Kneel on the opposite side of the patient and roll the patient toward you.
3. As the patient lies on their side while resting against you, reach across and
grab the blanket.
4. Tightly tuck half of the blanket lengthwise under the patient and leave the
other half lying flat.
5. Gently roll the patient onto their back.
6. Pull the tucked portion of the blanket out from under the patient and wrap
it around the body.
7. Grasp the blanket under the patient's head to form a support and means
for pulling.
8. Pull while backing up and while observing the patient at all times.
TWO MAN CARRY
SEAT CARRY
- Is a method of lifting and moving a victim in which two rescuers form a “seat” with their
arms
Version one: The hammock variation
1. Raise the victim to a sitting position. Each
first aider steadies the victim by positioning
an arm around the victim’s back.
2. Each first aider slips another arm to the
victim’s thighs, then clasp the risk of the
other first aider. One pair of arms should
make a seat and the other should make a
back rest.
3. Slowly raise the victim from the ground
moving in unison.
Version two: The interlocking wrist variation
1. Both the rescuers face each other, with their handsout.
2. Each rescuer takes their left hand and grabs their